Unplanned readmission and outpatient examination 90-days after acute appendectomy in adults

The aim of this study was to determine the frequency and indications for unplanned readmission and outpatient examination after acute appendectomy.

Adults who underwent acute appendectomy from 2008-2013 were included in the study and events occurring within 90-days from discharge recorded.

A total of 710 patients underwent surgery. The appendix was removed in 622 patients and post-discharge contact occurred in 99 (15.9%): readmission in 60 (9.6%), outpatient examination in 39 (6.3%). The main reasons for post-discharge contact were infection (n = 25; intraabdominal, n = 16; superficial) and abdominal pain of uncertain cause (n = 25). Use of prophylactic antibiotics was associated with lower rates of contact, 8.5% versus 20.9% (p = 0.006), respectively. Removal of non-inflamed appendix was borderline associated with higher rates of contact, 21.7% versus 8.0% (if left in-situ; p = 0.058), respectively.

A substantial number of patients underwent readmission or outpatient examination within 90-days after appendectomy in the current study. The procedure is common and attempts to prevent readmissions are important. Correct use of antibiotics and not removing a non-inflamed appendix may be key points.